title: Human papillomavirus prevalence in a population of women living in Port-au-Prince and Leogane, Haiti.
abstract: BACKGROUND
  There have been no published studies of carcinogenic human papillomavirus (HPV)--the necessary cause of cervical cancer--in Haiti, a nation that has one of the greatest burdens of cervical cancer globally.
  
  
  OBJECTIVE
  Characterize prevalence of carcinogenic HPV and the prevalence of individual carcinogenic HPV genotypes in women with cervical precancer or cancer, cervical intraepithelial neoplasia grade 2 (CIN2) or more severe (CIN2+).
  
  
  METHODS
  Women (n=9,769; aged 25-60 years) were screened for carcinogenic HPV by Hybrid Capture 2 (HC2; Qiagen, Gaithersburg, MD). Carcinogenic HPV positives underwent colposcopy and visible lesions were biopsied. A subset of carcinogenic HPV positives was tested for individual HPV genotypes using a GP5+/6+ assay.
  
  
  RESULTS
  The prevalence of carcinogenic HPV was 19.0% (95% confidence interval: 18.4%-19.9%) and decreased with increasing age (ptrend < 0.001). Women with 3 or more sexual partners and who started sex before the age of 18 years had twice the age-adjusted prevalence of carcinogenic HPV of women with one partner and who started sex after the age of 21 (24.3% vs. 12.9%, respectively). HPV16 and HPV35 were the most common HPV genotypes detected in CIN2+ and more common in women with CIN2+ than those without CIN2+. HPV16 and/or HPV18 were detected in 21.0% of CIN2 (n = 42), 46.2% of CIN3 (n = 52), and 80% of cancers (n = 5).
  
  
  CONCLUSIONS
  The prevalence of carcinogenic HPV in Haiti was much greater than the prevalence in other Latin American countries. High carcinogenic HPV prevalence and a lack of cervical cancer screening may explain the high burden of cervical cancer in Haiti.
authors.affiliation: Family Health Ministries, Durham, North Carolina, United States of America ; Duke Global Health Institute, Durham, North Carolina, United States of America.
authors.forename: David K
authors.initials: DK
authors.lastname: Walmer
authors.forename: Paul S
authors.initials: PS
authors.lastname: Eder
authors.forename: Laura
authors.initials: L
authors.lastname: Bell
authors.forename: Hiam
authors.initials: H
authors.lastname: Salim
authors.forename: Lori
authors.initials: L
authors.lastname: Kobayashi
authors.forename: Jackie
authors.initials: J
authors.lastname: Ndirangu
authors.forename: Nicole
authors.initials: N
authors.lastname: Tinfo
authors.forename: Philip E
authors.initials: PE
authors.lastname: Castle
mesh_terms: D000328:Adult; D005260:Female; D005838:Genotype; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology